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Hematuria in trauma

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Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also regarding your thought processes and the evidence behind your decisions. We can learn from each other!

For pediatric blunt trauma patients…

What degree of hematuria prompts further work-up in pediatric trauma patients?

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pemsou5_wp • March 23, 2018

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  1. Kelly April 8, 2018 - 3:22 pm Reply

    There is not a lot of literature on this topic. Experts have endorsed working up pediatric patients with microscopic hematuria of 20-50 wbc/hpf. Perez-Brayfield et al retrospecitively studied 110 patients with blunt trauma and hematuria aged 1-18yr, mean 9yr (J Urology 2002;167:2543) and recommended work-up for > 50 rbc, hypotension, severe mechanism of injury such as high speed MVA deceleration injury. Santucci et al retrospectively studied 720 patients with suspected renal injury (59 injuries identified) aged 0-17 yr, mean 8yr (J Urology 2004;171:822) and recommended work-up if gross hematuria, shock, significant deceleration injury (similar to criteria used for adult patients).

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